Primary Nursing is for the BIRDS - Page 2

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  1. Asst. Admin
    Aug 21, '12 by
    Quote from mindlor
    Hi Altra...

    I did quit, but a few days later the nurse manager called me and we negotiated for my return to the job.

    So here I am. I have good days and bad but I will say more are good.

    I am blessed with awesome coworkers and good management. Those two things make the job bearable.....
    This is the very reason there are such turnovers in LTAC's....do they have any aides at all?

    I have run the gamut. I have done team nursing with LPNs and aides. I have done "POD" nursing and primary care. I found primary care for 4 acutely ill step down ICU patients very challenging (we took vents there were no LTAC's then) but we shared an aide for every 15 patients.

    I find I have liked team nursing with LPNs and aides the most fulfilling for floor nursing but I prefer the ICU/CCU/CTPACU/TRU for this very reason.

    You need to be super organized and some days super human. When I supervised a LTAC I always pitched in for the patients were so sick one nurse couldn't really care for them all well.

    But you have something that can't have a value placed....good co-workers and good management. Chin up!
    Last edit by Esme12 on Aug 21, '12
    RN In FL likes this.
  2. Aug 21, '12 by
    To me.....Primary nursing IS NURSING!!! Some may call it "being a half a** CNA", but if you are organized, with a CNA, then it can be done. If you are scatter-brained and are unable to prioritize....then HANG IT UP!!!, you will dislike primary nursing. I feel the key is to get your patients in order at the beginning of the shift and things will flow...especially on a med/surg unit. J/S
    Fiona59 and Pepper The Cat like this.
  3. Asst. Admin
    Aug 21, '12 by
    Quote from RN In FL
    If you are scatter-brained and are unable to prioritize....then HANG IT UP!!!, you will dislike primary nursing.
    OP is a new nurse. Perhaps it is way too early in the game to tell him to hang it up. It takes some new grads a year or two to find their groove.
    Hygiene Queen, redhead_NURSE98!, amoLucia, and 6 others like this.
  4. Aug 21, '12 by
    Where I am, primary nursing means that there is no CNA......there is only me......so if I go in to hang a piggy pack and the pt is covered in poop then I have to priotitize, hang the IV first or clean poop lol
    Fiona59, anotherone, and redhead_NURSE98! like this.
  5. Asst. Admin
    Aug 21, '12 by
    Quote from RN In FL
    To me.....Primary nursing IS NURSING!!! Some may call it "being a half a** CNA", but if you are organized, with a CNA, then it can be done. If you are scatter-brained and are unable to prioritize....then HANG IT UP!!!, you will dislike primary nursing. I feel the key is to get your patients in order at the beginning of the shift and things will flow...especially on a med/surg unit. J/S
    The OP is employed in an LTAC...long term acute care....... and most likely has 4 medically complex patients 2 of them trached, vented on a cardiac monitor having weaning trials and the others could be totals as well with complex designs, chest tubes and a halo traction with tube feedings total care and medically complicated hospital courses.

    These patients are challenging to even the most seasoned of nurses. I have seen patients on the general floor in a LTAC that were higher acuity than the ICU down the road. Every hospital dumps/places these medically complex patients to these facilities. They are licensed acute care but care for patients long term. All of these medically complex patients, from multiple facilities, are under one roof one one floor.

    There are better tasks that can be accomplished by the aides so that the RN can accomplish the tasks that require a license.

    The OP is a new grad and I Think it is a little precipitous to "Hang it up" which reminds me...mindlor I don't know if I have shared my brains sheets before......


    i made some for nursing students and some other an members have made these for others.....adapt them way you want. i hope they help

    mtpmedsurg.doc] 1 patient float.doc‎]
    5 pt. shift.doc‎]
    finalgraduateshiftreport.doc‎]
    horshiftsheet.doc‎]
    report sheet.doc‎]
    day sheet 2 doc.doc]

    critical thinking flow sheet for nursing students]
    student clinical report sheet for one patient]
    Last edit by Esme12 on Sep 6, '12
    anotherone, redhead_NURSE98!, and microtutor like this.
  6. Aug 21, '12 by
    Fifteen whole shifts, huh.

    It'll get better.
  7. Aug 21, '12 by
    Thank you Esme

    My nurse educator told me that a good nurse knows that each shift they will have 100 tasks to do but they will only be able to do 70, Therefore they must choose which 70 are not going to get done.

    Cool.

    The only problem is that with our charting system all 100 must be checked off, therefore if I follw the advice of this person.....I will have to lie 30 percent of the time......

    I have the full support of my Nurse Manager...many are scared of her but I communicate with her honestly and I think she really appreciates it. She really is awesome. She is new to the favility and also hates the computer system that we use lol......

    What scares me is that at any given time I am juggling so many balls, if I drop one that happens to cause great harm then my license will evaporate.......its pretty scary....
    Vespertinas likes this.
  8. Aug 21, '12 by
    LOL thank you GrnTea. It is getting better My specialty is managing family and I have gotten and given many hugs......I just widh I had more time to really provide the care that I want to provide.....
    Ayvah, GrnTea, and Vespertinas like this.
  9. Aug 21, '12 by
    Quote from Esme12
    The OP is employed in an LTAC...long term acute care....... and most likely has 4 medically complex patients 2 of them trached, vented on a cardiac monitor having weaning trials and the others could be totals as well with complex designs, chest tubes and a halo traction with tube feedings total care and medically complicated hospital courses.

    These patients are challenging to even the most seasoned of nurses. I have seen patients on the general floor in a LTAC that were higher acuity than the ICU down the road. Every hospital dumps/places these medically complex patients to these facilities. They are licensed acute care but care for patients long term. All of these medically complex patients, from multiple facilities, are under one roof one one floor.

    There are better tasks that can be accomplished by the aides so that the RN can accomplish the tasks that require a license.

    The OP is a new grad and I Think it is a little precipitous to "Hang it up" which reminds me...mindlor I don't know if I have shared my brains sheets before......


    i made some for nursing students and some other an members have made these for others.....adapt them way you want. i hope they help

    mtpmedsurg.doc] 1 patient float.doc‎]
    5 pt. shift.doc‎]
    finalgraduateshiftreport.doc‎]
    horshiftsheet.doc‎]
    report sheet.doc‎]
    day sheet 2 doc.doc]

    critical thinking flow sheet for nursing students]
    student clinical report sheet for one patient]
    Oh my, I totally stand corrected. I BEG YOUR PARDON.....:bowingpur
  10. Aug 21, '12 by
    I have found that when I'm forced to wear two hats, CNA and RN, I don't wear either adequately. I go home feeling like a loser because I'm not proud of the way I performed either job.
    It doesn't happen often, but I hate it. I don't mind "helping" the CNA, but I don't want that job on top of my own.
    Fiona59, Szasz_is_Right, anotherone, and 1 other like this.